| NPI | 1154915494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist Dentist Anesthesiologist (Licence: NC 13609) |
| Additional Taxonomies | 1223D0004X Dentist Dentist Anesthesiologist (Licence: PA DS045029) |
| 1223D0004X Dentist Dentist Anesthesiologist (Licence: SC 10600) | |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2025-04-10 |